Malaria: The Dilemmas of Malarial Diagnostics

Introductionpractice the diagnosis of malaria is usually relatively easy. In the acute situation a blood film is sent and if the result is positive the patient is started on appropriate therapy. The dilemma arises if after several days a patient still exhibits symptoms and signs of malaria yet numerous blood films for parasites have not provided a conclusive diagnosis. Is there a place for blind therapy? This article looks at the guidelines set out by the School of Hygiene and Tropical Medicine and demonstrates that the criteria for diagnosis, tracking improvement and discharge, although straightforward, are not always easy to implement. The difficulties with traditional diagnosis are examined with regard to a cohort of 21 patients admitted to Frimley Park Hospital over a three-month period. All patients had a diagnosis of pyrexia thought to be malaria, having recently returned from an area with endemic malaria. We will also consider the effectiveness and cost efficiency of alternative investigations for malaria. Prevalenceis caused by the plasmodium species